The present invention relates generally to medical devices and more particularly to a passing device for use in performing tenorrhaphy and similar surgical procedures.
A wide variety of procedures and equipment are used to perform tenorrhaphy, the union of a divided or ruptured tendon by suturing or tenodesis, the suturing of the end of a tendon to a bone. Tendon repair is difficult to satisfactorily perform, especially in the digits, due to the size and other characteristics of tendons, their associated tendon sheath and correspondingly small surgical field.
During tendon repair, it is important to minimize any further damage to a lacerated tendon and its associated sheath. Often, the lacerated ends of a tendon are not available at the laceration site in the associated sheath. Even if lacerated ends of a tendon can be grasped through the laceration site in the associated sheath, it may not be possible to deliver a sufficient length of tendon from the laceration site to accomplish a suture repair. Thus, additional openings are often surgically created proximal and distal to the laceration site in the associated sheath to allow extracting lacerated ends of the tendon from the sheath. Sutures may then be respectively placed in the lacerated ends of the tendon. The tendon ends and sutures must then be passed back into the sheath through the respective surgical openings to allow completion of the tendon repair within the associated sheath. Lacerated tendon ends tend to fray when handled, especially when an attempt is made to pass the tendon ends through tight openings in the associated sheath.
Accordingly, a need has arisen for improved equipment and methods to protect the ends of lacerated tendons, ligaments and other types of fibrous body tissue. One aspect of the present invention includes an elastomeric tube and an applicator for placing the elastomeric tube over the lacerated end of a tendon, ligament and other fibrous body tissues.
Technical benefits of the present invention include tendon repair procedures and equipment satisfactory for use with contemporary surgical practices and rehabilitation programs. Tendon passing devices and associated tendon repair procedures incorporating teachings of the present invention substantially reduce or eliminate further damage to a tendon and its associated sheath during tenorrhaphy. Such tendon passing devices and associated tendon repair procedures substantially reduce or eliminate fraying of the ends of a ruptured or lacerated tendon during tenorrhaphy and/or when passing a tendon graft through a bone tunnel.
Another aspect of the present invention includes providing apparatus and methods which may be used to repair lacerated tendons or ligaments in a patient""s upper and lower extremities. Apparatus and methods incorporating teachings of the present invention may also be used to pass tendons, tendon grafts or fibrous body tissues through bone tunnels during reconstructive surgery such as to repair ligament injury or damage from arthritis and other diseases. Apparatus and methods incorporating teachings of the present invention may also be used during tendon transfers associated with treatment of palsies and reconstruction of congenital deformities.
Further technical benefits of the present invention include protecting the lacerated ends of a tendon or other types of fibrous body tissue during a surgical procedure. For some procedures such as tenorrhaphy, surgical openings may be formed in the sheath of a lacerated tendon at optimum locations proximal and distal to the laceration site to allow extracting respective lacerated ends of the tendon from the sheath. Sutures may be placed in each lacerated end of the tendon for use in repairing the tendon. Each tendon end is preferably covered with a respective elastomeric tube to provide protection from fraying or other damage while passing the lacerated end of the tendon and associated suture strands through the respective surgical opening. The elastomeric tubes and suture strands cooperate with each other to aid in positioning the lacerated ends of the tendon at the optimum position within the associated sheath for completion of the tendon repair.